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[气管支气管结核的外科治疗]

[Surgical treatment for tracheobronchial tuberculosis].

作者信息

Kikuchi K, Kobayashi K

机构信息

Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Kekkaku. 1997 Jan;72(1):43-8.

PMID:9038015
Abstract

We treated thirty nine patients with tuberculous tracheobronchial stenosis. Age varied from 22 to 53 years old (mean 32y.o.). Thirty one were female and eight were male. Main stenotic sites of the tracheobronchus were trachea in 3 cases, tracheal bifurcation in 2 cases, right main bronchus in 6 cases, left main bronchus in 25 cases, right intermediate bronchus in 2 cases, right lower lobe bronchus in 1 case. The modes of operations were tracheal sleeve resection + 1t. pneumonectomy + T tube insertion to the trachea in 1 patient, laser irradiation + T tube insertion to the trachea in 2 patients, carinal reconstruction in 2 patients, bronchial dilatation by Gebauer in 1 patient, left sleeve upper lobectomy in 13 patients, sleeve resection of the left main bronchus in 9 patients, sleeve resection of the left main bronchus + left upper lobectomy in 2 patients, right upper sleeve lobectomy in 5 patients, right upper wedge lobectomy in 1 patient, sleeve resection of the right intermediate bronchus in 2 patients, right S6 sleeve segmentectomy in 1 patient. One patients died of pulmonary edema. Anastomotic stenosis occurred in 4 patients. We conclude tracheobronchial reconstruction and stent tube therapy is very useful technic for preserve pulmonary function in patients with tracheobronchial tuberculosis.

摘要

我们治疗了39例结核性气管支气管狭窄患者。年龄在22岁至53岁之间(平均32岁)。女性31例,男性8例。气管支气管的主要狭窄部位为气管3例、气管隆突2例、右主支气管6例、左主支气管25例、右中间支气管2例、右下叶支气管1例。手术方式包括:1例患者行气管袖状切除+左全肺切除+气管内插入T管;2例患者行激光照射+气管内插入T管;2例患者行隆突重建;1例患者行Gebauer支气管扩张术;13例患者行左袖状肺叶切除术;9例患者行左主支气管袖状切除术;2例患者行左主支气管袖状切除+左上肺叶切除术;5例患者行右上袖状肺叶切除术;1例患者行右上楔形肺叶切除术;2例患者行右中间支气管袖状切除术;1例患者行右S6袖状段切除术。1例患者死于肺水肿。4例患者发生吻合口狭窄。我们得出结论,气管支气管重建和支架管治疗对于保留气管支气管结核患者的肺功能是非常有用的技术。

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